Arulselvan, A (2018) A comparative study between laparoscopic and open cholecystectomy in Chengalpattu Medical College. Masters thesis, Chengalpattu Medical College, Chengalpattu.
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Abstract
BACKGROUND: Gallstones occurrence is one of the commonest disease processes treated by general surgeon. In 1882 Carl Langenbuch performed the first cholecystectomy, enunciating a principal that the gall bladder needs to be removed not because it contains stones, but because it forms them. Over the years cholecystectomy has been the gold standard in the treatment of gall stone disease. Open cholecystectomy which had been performed unchallenged for over a century now faces an abrupt end with advent of laparoscopic cholecystectomy. In 1985 Philipe Mouret from France performed the first Human Lap Cholecystectomy. Patient acceptance, preference and demand for laparoscopic cholecystectomy is logical since this procedure gives less pain , need for less medication, far shorter hopitalisation and most important it permits an early return to family and normal work and activity. As an added bonus it has an excellent cosmetic result. Laparoscopic cholecystectomy further offers the long term benefit of negligible incidence of wound infection, incisional hernia, nerve entrapment and post operative adhesions. In the field of laparoscopy, laparoscopic cholecystectomy has been the first major surgery performed and has paved the path for laparoscopic intervention for other varied intra abdominal pathologies. So we will study both the techniques and their standing in present scenario. With the background of experience in open cholecystectomy we will commence our work on laparoscopic cholecystectomy. OBJECTIVES OF THE STUDY: 1. Comparative study of the duration of Surgery in both groups. 2. Comparative study of post operative hospital stay, drugs used, Time taken for return to work and Study of conversion rate to open surgery. 3. Comparative study of post-operative complications mortality and morbidity in both groups. MATERIALS AND METHODS: Source of data: Study is a prospective type which includes all patients admitted in Chengalpattu Medical College for elective cholecystectomy. Method of collection of data (including sampling procedure if any: Definition of a study subject: Patients admitted to Department of Surgery, Chengalpattu Medical College for Elective Cholecystectomy. The method of study consists of;- • Detail history taking & clinical examination as per the proforma. • Investigations after taking written informed consent. • Patients will be explained about types of surgeries available-laparoscopic or open cholecystectomy. • Intraoperatively careful note will be made about • Time latent for the procedure • Documentation of any complication encountered during procedure. • If laproscopic procedure converted to open cholecystectomy, reason for the same. • Post operative period will be divide into immediate or in hospital stay and follow up period during in hospital stay, following data will be collected: • Drain removal ,if put. • Post operative hospital stay. • Any complication if occurred. • Patients of both groups will be followed regularly up to 3 months. • Note will made of any complications, time taken to return to work and patients satisfaction. Inclusion criteria: 1. Patients with symptomatic gallbladder diseases 2. Symptomatic gallstones. 3. Acute or Chronic cholecystitis. 4. Mucocele/ Pyocele of gallbladder. Exclusion criteria: 1. Pregnancy. 2. Major bleeding disorder. 3. Cirrhosis with portal hypertension. 4. Generalised peritonitis. 5. Patient not fit for general anaesthesia. 6. Suspected gall bladder malignancy The following investigations will be done after taking written informed consent:- 1. Routine Investigations for General Surgical Procedure Blood Investigation and Urine Investigations :Hb%, TC , DC, Peripheral smear, ESR, Renal function tests, Liver function tests, Lipid profile, FBS/PPBS, HIV, HBsAg, , Urine for albumin, sugars, ketone bodies, microscopy, BT CT. Other investigations : X-ray of the chest, X-ray Erect Abdomen, Ultrasonogram of Abdomen, Serum amylase. In selected cases MRCP, ERCP, CT Abdomen CONCLUSION: The above study is to evaluate the superiority of laparascopic cholecystectomy over open cholecystectomy in Chengalpattu Medical College Hospital during the period September 2015 to October 2016.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | laparoscopic ; open cholecystectomy ; Chengalpattu Medical College ; comparative study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Sep 2018 15:09 |
| Last Modified: | 10 Sep 2018 15:09 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/9493 |
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